RMD and COVID19: The EULAR perspective

From the beginning of the year, the SARS-CoV-2 pandemic, starting in China, has struck the world and has made many casualties, especially among the elderly and among those with impaired health due to comorbidities The distribution rate of SARS-CoV-2 across the world has been unpredictable, and the top-ten countries in terms of impact of COVID19 were not the same in March and April as compared to today The public health measures that were taken around the world also markedly varied It was expected that COVID19 would hit patients with rheumatic musculoskeletal diseases (RMD) disproportionally hard, because many RMD-patients use drugs that suppress the immune system and could reduce viral clearance Because of that, EULAR started two initiatives early in April 2020: The COVID19 task force and the EULAR RMD-COVID-registry The task force had to develop recommendations for the management of COVID19 in the context of SARS-CoV-2 The EULAR registry aimed at collecting data about the risk patients with RMDs face with regard to contracting SARS-CoV-2 and with regard to COVID19 recovery The EULAR provisional recommendations saw the light at the virtual EULAR on June 3 The EULAR registry delivered data that gave a relatively reassuring picture with regard to the risks of RMD-patients In the mean time it has become clear that COVID19-fatality was strongly associated with a state of virus-induced hyperinflammation, and that immunosuppressants, such as those used by RMD-patients, were helpful rather than deleterious In this lecture the current state of the art of the pandemic will be reviewed in relation to its recent history, the risk of RMD patients will be looked at, and the EULAR recommendations will be briefly discussed The conclusion will be that-although updates have been planned already-the content of the EULAR recommendations is unabatedly up-to-date